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Prevention and treatment of viral disease Flashcards

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1
Q

Prophylaxis

A

preventing disease before aetiologic agent is acquired, by vaccination or giving drug before infection.

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2
Q

Therapy

A

treating disease after host has been infected

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3
Q

Vaccines

A 
Prophylactic
Live or inactive
Herd immunity or defined target group 
Safety > efficacy (RSV vaccine in 1970s)
Controlled by Governments and WHO
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4
Q

Antiviral drugs

A

Therapeutic
Random screen or rational design
Define target group: very sick or over the counter
Prescribed on an individual basis

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5
Q

Immunological basis of protection after vaccination

A

1st Infection: Acquired specific immune response

2nd Exposure: Response is rapid and potent, only mild/ inapparent infection

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6
Q

What led to the eradication of smallpox?

A

Scrape pox virus spore onto arm to give mild infection that would protect them against worse
No animal reservoir for smallpox (only human)
No latent or persistent infection (acute)
Smallpox was an easily recognised disease

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7
Q

Smallpox vaccine

A

effective against all strains of virus

Potent, low cost, abundance, heat stabile, easily administered

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8
Q

Live attenuated vaccine

A

live virus has its virulence reduced and then is administered to the patient

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9
Q

Inactivated vaccine

A

virus genome is destroyed so that it is still stimulates a response but can no longer be infectious
given with adjuvant

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10
Q

Purified subunit vaccine

A

viral genome treated with proteases which chop it into subunits
these have antigens that can trigger an immune response.

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11
Q

Cloning vaccine

A

viral genome cloned in a bacterium and the copies of the genome are either:
Injected into people
Put into virus-like particles

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12
Q

Give 7 examples of viruses for which live attenuated vaccines are effective against

A 
Influenza
Measles 
Mumps
Rubella
Polio
Varicella zoster virus
Smallpox
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13
Q

Give 3 examples of viruses for which inactivated vaccines are effective against

A

Hepatitis A
Polio
Rabies

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14
Q

Give an example of a virus for which purified subunit vaccines are effective against

A

Influenza

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15
Q

Give 2 examples of viruses for which cloned subunit vaccines are effective against

A

Hepatitis B

Human papillomavirus

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16
Q

How are Live Attenuated Vaccines made?

A

Pathogenic virus isolated from patient and grown in human cultured cells
Cultured virus used to infect monkey cells
Virus acquires many mutations that allow it to grow well in monkey cells
Virus no longer grows well in human cells and may be candidate for vaccine

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17
Q

Pros of using a live attenuated vaccine

A

Rapid broad, long lived immunity
Dose sparing
Cellular immunity

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18
Q

Cons of using a live attenuated vaccine

A

Requires attenuation

May revert

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19
Q

Pros of using an inactivated vaccine

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A

Safe

Can be made from wild type virus

20
Q

Cons of using an inactivated vaccine

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A

Frequent boosting required

High doses needed

21
Q

What types of vaccines are available for influenza?

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A

Live attenuated

Purified subunit

22
Q

What types of vaccines are available for polio?

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A

Live attenuated: SABIN

Inactivated: SALK

23
Q

What type of vaccine does rotavirus have?

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A

Live attenuated reassortant

24
Q

How are recombinant attenuated virus vaccines made?

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A

The virulence gene is either mutated or deleted

25
Give 2 examples of anti-cancer subunit vaccines
Hepatitis B: Surface antigen cloned and expressed in yeast | HPV: Virus like particles from recombinant coat proteins
26
How can we use viruses against viruses?
Can GM viruses to express certain proteins | Make viruses that deliver genetic material into cells
27
Name 2 vaccines against Ebola
GSK: Chimpanzee adenovirus vectored vaccine that expresses Ebola G protein Merck: Vesicular Stomatitis Virus vectored vaccine expressing Ebola virus G protein.
28
How do Ebola vaccines work?
Clone Ebola G protein into other viruses that don’t cause disease Use as vector to deliver Ebola G protein, to initiate immune response that will defend against Ebola
29
How is Ebola virus treated?
Passive immunisation: Zmapp Serum therapy
30
What is Zmapp?
Mix of 3 monoclonal antibodies raised against G protein of a previous strain of Ebola virus given as passive immunotherapy
31
What is serum therapy?
transfer blood from survivors into other person
32
3 Antiviral treatment approaches
Interferons to induce the hosts natural antiviral response Drugs with specific antiviral activity Treatment that alleviate symptoms but do not inhibit virus replication
33
Antiviral treatments: Interferons
Enhances own natural antiviral system On infection, cell recognises virus as being foreign, so secretes interferons They signal to other cells to ‘ramp up’ expression of interferon stimulator genes Protects against virus
34
What are the limitations of using interferons as antiviral treatment?
Activates inflammation and fever | Can make the patient feel even more ill
35
Why is it difficult to develop directly acting antiviral drugs?
Viruses mimic/ use many healthy cells, so selectivity would harm healthy cells
36
What do most antiviral drugs target?
Viral enzymes Often act as substrate analogues (look like enzyme substrate, but slightly different so clog enzyme) or are cancer like drugs- nucleoside analogues (block replication)
37
How do nucleoside analogues inhibit viral replication?
Chain termination Modified nucleoside incorporated into DNAlacks of 3’ -OH Prevents phosphodiester bond formation
38
How is acyclovir specific?
Only activated inside virus infected cells | Higher affinity for viral DNA polymerase than for host cell polymerase
39
Resistance to acyclovir
Rare but maps to thymidine kinase
40
How does Neuraminidase provide a target for drugs?
Crystal structure of neuraminidase allows us to see how substrate binds into enzyme and how it works
41
What is sialidase enzyme also known as, and what is it?
Neuraminidase | Spike protein on outside of influenza virus
42
Name 2 drugs that inhibit Neuraminidase
Zanamivir | Oseltamivir
43
Neuraminidase inhibitors
Drugs created that look like substrate (Sialic acid) but are chemically different Bind irreversibly into enzyme active site
44
Active retroviral therapy for HIV includes drugs that block:
Entry of HIV into cells Early stages of infection Integration of virus DNA into hosts DNA Processing of proteins of virus
45
Name 4 types of drugs that treat Hepatitis C
Protease inhibitors N5SA NNPI NSSB polymerase inhibitors
46
How was Hepatitis C treated for over 20 years?
Therapy relied on interferon treatment with ribavirin

Microbiology (9 decks)

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